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Tag Archives: physiological stress

September 2025 Br J Cardiol 2025;32:113 doi:10.5837/bjc.2025.042

Correspondence – Trigger-induced peri-operative atrial fibrillation in non-cardiac surgery: to anticoagulate, or not to anticoagulate, that is the question

Zeina Othman, Betsy Dwyer, Constantinos G Missouris, Amit K J Mandal

Abstract

The late 2024 European Society of Cardiology (ESC) AF guidelines2 recognise ‘trigger-induced AF’ as a distinct clinical entity, which, we propose, might be defined as incident AF in the face of physiological stress and potentially reversible arrhythmogenic substrate(s). The temporal pattern of AF is almost invariably paroxysmal, and typically self-terminates within 48 hours, once the underlying cause has been addressed. Peri-operative AF (POAF) in non-cardiac surgery is frequently encountered throughout all phases of the peri-operative journey, and is multi-faceted in aetiology. A single 12-lead resting electrocardiogram (ECG) or a 30-sec

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